How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier None Typical Low $0.09 Median $0.22 Typical High $0.22 | Professional | None | $0.09 | $0.22 | $0.22 |
BCBS Idaho Setting Facility Modifier None Typical Low $0.12 Median $0.16 Typical High $0.24 | Facility | None | $0.12 | $0.16 | $0.24 |
BCBS Idaho Setting Professional Modifier None Typical Low $0.11 Median $0.16 Typical High $0.17 | Professional | None | $0.11 | $0.16 | $0.17 |
Cigna Setting Facility Modifier None Typical Low $0.09 Median $0.09 Typical High $0.09 | Facility | None | $0.09 | $0.09 | $0.09 |
Cigna Setting Professional Modifier None Typical Low $0.08 Median $0.08 Typical High $0.09 | Professional | None | $0.08 | $0.08 | $0.09 |
Moda Health Setting Facility Modifier None Typical Low $0.05 Median $0.14 Typical High $0.22 | Facility | None | $0.05 | $0.14 | $0.22 |
Moda Health Setting Professional Modifier None Typical Low $0.11 Median $0.16 Typical High $0.22 | Professional | None | $0.11 | $0.16 | $0.22 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $0.12 Median $0.19 Typical High $8.91 | Facility | None | $0.12 | $0.19 | $8.91 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $0.15 Median $0.19 Typical High $10.47 | Professional | None | $0.15 | $0.19 | $10.47 |
Regence BlueShield Setting Professional Modifier None Typical Low $0.11 Median $0.11 Typical High $0.16 | Professional | None | $0.11 | $0.11 | $0.16 |
Select Health Setting Facility Modifier None Typical Low $0.15 Median $0.15 Typical High $0.24 | Facility | None | $0.15 | $0.15 | $0.24 |
Select Health Setting Professional Modifier None Typical Low $0.10 Median $0.15 Typical High $0.17 | Professional | None | $0.10 | $0.15 | $0.17 |
United Setting Professional Modifier None Typical Low $0.06 Median $0.07 Typical High $0.13 | Professional | None | $0.06 | $0.07 | $0.13 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.03 Median $0.03 Typical High $0.03 | Professional | 55 · Aftercare only | $0.03 | $0.03 | $0.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 56 · Pre-op care only | $0.02 | $0.02 | $0.02 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $0.10 Median $0.11 Typical High $0.12 | Professional | 78 · Unplanned return to OR | $0.10 | $0.11 | $0.12 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.03 Median $0.03 Typical High $0.03 | Professional | 55 · Aftercare only | $0.03 | $0.03 | $0.03 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 56 · Pre-op care only | $0.02 | $0.02 | $0.02 |
Where Idaho sits
The same service costs 2.0 times more in Idaho than in Ohio. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Idaho· 1st of 51
$0.16
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.